VIP Peptide (Aviptadil): CIRS Evidence, Risks and Status (2026)

Quick answers

What is it?: A natural chain of 28 amino acids that nerve cells release as a signal; it was first found in the gut⁵⁶. It widens blood vessels and adjusts immune activity⁶. Aviptadil is the drug name for the lab-made version⁷.
Does it work?: Unproven for its main use: we found no test of it against a placebo for mold illness². In COVID-19 lung failure, a 461-patient trial found no benefit⁴. Erection shots work, but they combine it with another drug⁸.
Is it safe?: In a COVID-19 trial, 32.8% of patients given IV drips had diarrhea, versus 1.5% on placebo⁹. Erection shots often cause flushing⁸. The safety of nasal sprays rests on small studies without a placebo group²¹⁰.
Is it legal?: It is not FDA-approved for any use¹¹. US pharmacies may make it for now while FDA reviews it¹²¹³. Sweden approves it in an erection shot¹⁴. Australia makes it prescription-only¹⁵. Sport’s banned list does not name it¹⁶¹⁷.
What is in the vials?: Unknown. As of 7 October 2026, Finnrick, a testing service, listed no tests of VIP¹⁸. Online sellers offer 10 mg vials labeled for research use only¹⁹²⁰. Canada has seized injectable peptides sold as VIP²¹²².

What it is

VIP (vasoactive intestinal peptide) is a chain of 28 amino acids whose last amino acid carries an amide cap⁶²³. It is a neuropeptide: nerve cells in the brain and throughout the body release it as a signal, and it acts on two receptors, VIP receptor 1 and VIP receptor 2⁶. UniProt, a protein database, describes its main roles as protecting nerve cells and adjusting immune activity; it also widens blood vessels, lowers blood pressure, strengthens heart contractions and relaxes the smooth muscle of the windpipe, stomach and gallbladder⁶. In a small sarcoidosis study, inhaled VIP lowered the release of the inflammatory signal tumor necrosis factor-alpha by immune cells washed out of the lungs²⁴. Aviptadil, the drug name for lab-made VIP, is described by the European Medicines Agency as identical to the natural hormone⁷.

Said and colleagues isolated VIP from hog small intestine and reported in 1970 that it has 28 amino acids and widens blood vessels⁵. A 1978 study gave it by IV infusion to four healthy volunteers²⁵. In the 1990s it was tested for erectile dysfunction, alone and then combined with phentolamine⁸²⁶, and Sweden first approved such a combination, Invicorp, in May 2015¹⁴. The Liechtenstein company mondoBIOTECH Laboratories obtained EU orphan designations for aviptadil in acute lung injury in 2006 and in sarcoidosis in 2007⁷²⁷. During the COVID-19 pandemic, NRx Pharmaceuticals and Relief Therapeutics developed an IV form, Zyesami, which FDA twice declined to authorize for emergency use²⁸²⁹³⁰.

Benefits: what the research shows

The largest trials tested IV aviptadil in critically ill COVID-19 patients, and neither showed a clear benefit. In TESICO, a placebo-controlled trial at 28 US sites funded by the US National Institutes of Health, 471 adults with COVID-19 lung failure were randomly assigned to 3 days of aviptadil or placebo drips; 461 received at least part of a drip, and 94% of them were in intensive care⁴. Recovery at day 90 did not differ (odds ratio 1.11, 95% CI 0.80 to 1.55), 38% versus 36% died, and on 25 May 2022 the trial’s safety board recommended stopping it for futility, meaning it was unlikely to show a benefit⁴. In COVID-AIV, a double-blind trial of 196 patients at 10 US hospitals funded by NRx Pharmaceuticals and Relief Therapeutics, the main goal of being alive and free of respiratory failure at day 60 was not met (odds ratio 1.6, 95% CI 0.86 to 3.11)⁹²⁸. Survival had been the original main goal until the goals were swapped in February 2021, at the data monitoring committee’s suggestion; the authors reported better 60-day survival (odds ratio 2.0, 95% CI 1.1 to 3.9; p = 0.035)⁹. An accompanying editorial said that, viewed conservatively, it was a negative study³¹. A 2025 review that pooled two randomized trials in lung failure found no survival benefit (odds ratio 1.01, 95% CI 0.72 to 1.42)³². Inhaled VIP has only smaller studies. In an 80-patient double-blind trial in Turkey, funded by Centurion Pharma, hospital stays were shorter (7.8 versus 10 days, p = 0.049), but deaths by day 180 did not differ significantly (5.1% versus 12.2%, p = 0.433)³³. In pulmonary hypertension, an 8-patient study reported lower lung artery pressure, while a 20-patient single-dose study found the effect “modest and short-lived”³⁴³⁵. In an open 4-week study of 20 people with sarcoidosis, inhaled VIP was well tolerated and lowered an inflammatory signal released by cells from lung fluid²⁴. For mold illness, the main reason people buy VIP, the evidence is thin. In a 2013 open-label study with no placebo group, Shoemaker and colleagues gave VIP nasal spray to 20 patients whose illness after exposure to water-damaged buildings had not resolved with earlier treatment, and reported that symptoms fell to the level of healthy controls in all of them¹⁰. Apart from single case reports, a 2024 review that favors the Shoemaker treatment plan lists three VIP studies, all from Shoemaker’s group, and rates each as a single nonexperimental study². The 2013 paper said a placebo-controlled trial had begun, but as of 7 October 2026 the US trial registry listed no trial of VIP for mold illness³¹⁰. The diagnosis itself is disputed: a 2019 review in an allergy and immunology journal concluded that “the existence of toxic mold syndrome has been disproven”, though it did not name CIRS³⁶. Erectile dysfunction is the one use with clear controlled evidence, and only for a combination: in a 236-man trial of VIP with phentolamine, 75% responded to the shot with 1 mg of phentolamine versus 12% to placebo⁸. The Welsh assessment of Invicorp counted two placebo-controlled trials with 343 men in total³⁷, and a 2025 single-center review of 308 men for whom alprostadil injections had failed or caused pain found the combination effective in 59%³⁸. Injected alone in a 24-man placebo-controlled trial, VIP did not produce erections firm enough for sex²⁶. In animal models of arthritis and of Crohn’s disease, VIP reduced inflammation and tissue damage³⁹⁴⁰; we found no controlled human trial of these effects.

Key human studies

Study	Design	People	Dose and route	Result
Brown et al., Lancet Respir Med 2023 (TESICO)⁴PubMed · DOI · NCT04843761 · NCT06729606	Randomized, placebo-controlled trial at 28 US sites (ACTIV-3b), funded by the US National Institutes of Health; adults hospitalized with COVID-19 and acute hypoxemic respiratory failure, 94% in intensive care	471	IV infusion over 12 hours daily for 3 days, targeting 600, 1,200 and 1,800 pmol/kg on days 1 to 3	Recovery at day 90 did not differ (odds ratio 1.11, 95% CI 0.80 to 1.55; p = 0.54). Deaths by day 90: 38% vs 36% (hazard ratio 1.04). Death, serious events, organ failure, serious infection or severe side effects by day 5: 63% vs 56% (p = 0.10). Stopped early for futility; 461 analyzed⁴.
Youssef et al., Crit Care Med 2022 (COVID-AIV)⁹PubMed · DOI · NCT04311697	Double-blind, placebo-controlled Phase 2b/3 trial at 10 US hospitals, randomized 2:1; adults with critical COVID-19 and respiratory failure	196	IV infusion over 12 hours on 3 successive days at 50, 100 and 150 pmol/kg per hour	Main goal (alive and free of respiratory failure at day 60) not met: odds ratio 1.6 (95% CI 0.86 to 3.11). Survival at day 60, the original main goal and later a key secondary goal, favored aviptadil (odds ratio 2.0, 95% CI 1.1 to 3.9; p = 0.035). Diarrhea 32.8% vs 1.5%⁹.
Shoemaker, House and Ryan, Health 2013¹⁰DOI	Open-label study without a placebo group; adults with chronic inflammatory response syndrome after exposure to water-damaged buildings, not resolved by earlier treatment	20	Nasal spray, 50 µg four times a day, later reduced; at least 18 months	Authors reported that symptoms fell to the level of healthy controls in all treated patients, with no significant side effects; one patient had a temporary rise in the pancreatic enzyme lipase¹⁰.
Esendagli et al., Med Princ Pract 2025³³PubMed · DOI · NCT04844580	Randomized, double-blind, placebo-controlled Phase 2 trial at 9 hospitals in Turkey, funded by Centurion Pharma; adults hospitalized with COVID-19 pneumonia who needed oxygen but not intensive care	80	Inhaled by mesh nebulizer: 200 µg a day (two 1 mL doses of a 100 µg/mL solution, 30 minutes apart) for 7 to 14 days, plus standard care	Average time to discharge 7.8 vs 10 days (p = 0.049). Deaths by day 180: 5.1% vs 12.2% (p = 0.433). No dropouts due to side effects³³.
Prasse et al., Am J Respir Crit Care Med 2010²⁴PubMed · DOI	Open-label Phase 2 study without a placebo group; adults with active sarcoidosis confirmed by biopsy	20	Inhaled (nebulized) VIP for 4 weeks; dose not given in the abstract	Safe and well tolerated. Cells from lung fluid released less tumor necrosis factor-alpha, and regulatory T cells in lung fluid increased²⁴.
Dinsmore et al., BJU Int 1999⁸PubMed · DOI	Multicenter, double-blind, placebo-controlled study at eight clinics; men with erectile dysfunction of mainly physical cause; VIP combined with phentolamine in an auto-injector	236	Injection into the penis: 25 µg VIP with 1 or 2 mg phentolamine	In the placebo-controlled phase (171 men), 75% responded to the 1 mg mix vs 12% to placebo, and 66% to the 2 mg mix vs 18% (P < 0.001). Flushing followed 40% of 1,711 injections; one priapism (0.06%)⁸.

Doses studied

Doses below are what studies used or what a label says. They are not advice, and gray-market products may not contain what their label says.

In human studies

IV: in COVID-AIV, 12-hour infusions of 50, 100 and 150 pmol/kg per hour on 3 successive days⁹; in TESICO, a 12-hour infusion each day for 3 days, targeting 600, 1,200 and 1,800 pmol/kg on days 1, 2 and 3⁴. A 1978 volunteer study infused 0.6, 1.3 and 3.3 pmol/kg per minute, each for 30 minutes²⁵. Inhaled: a single 100 µg dose in pulmonary hypertension³⁵; 200 µg a day by mesh nebulizer, as two 100 µg doses 30 minutes apart, for 7 to 14 days in COVID-19³³. Nasal spray: 50 µg four times a day, later reduced, in the 2013 open-label mold-illness study¹⁰. Injection into the penis: 25 µg VIP with 1 or 2 mg phentolamine per injection in trials⁸; the Swedish label for the 25 µg/2 mg product says injections should not exceed once a day or 3 times a week¹⁴. VIP alone was tested at 200 or 400 pmol per penile injection²⁶. We found no human study of VIP injected under the skin, the route many community pages list.

In animal studies

Mice with a chemically induced, Crohn’s-like colitis: 1 nmol of VIP per mouse, as a single dose 12 hours after the colitis was triggered or every other day⁴⁰. An arthritis study reported benefit, but its abstract gives no dose³⁹.

What users report Anecdotal · not validated · not a recommendation

A community dosing guide (dated 25 April 2026) lists 50 µg injected under the skin twice a day or 100 µg once a day, and nasal sprays of 50 µg per spray, 4 to 8 sprays a day. We found no controlled trial that tested these amounts.⁴⁸

Half-life: 1.7 minutes after IV injection¹⁴In healthy men, VIP from an Invicorp dose had a half-life of 1.7 minutes after IV injection and 5.3 minutes after injection into the penis, according to the Swedish product information¹⁴. A 1978 study in four healthy volunteers found an average disappearance half-time of one minute after IV infusion²⁵. We found no published half-life for nasal sprays or injections under the skin.
Routes: IV infusion (12-hour drips in COVID-19 lung-failure trials; human data)
Inhaled by nebulizer (small human studies in pulmonary hypertension and sarcoidosis, and COVID-19 trials)
Injection into the penis, combined with phentolamine (the approved use abroad, as Invicorp; human trials)
Nasal spray (sold by US compounding pharmacies for mold illness; small open-label studies only)
Injection under the skin (listed on community and seller pages; no human study found)

Every dose studied for VIP (vasoactive intestinal peptide), with sources →

Legal status

United States: Not approved for any use: Drugs@FDA, searched through openFDA on 7 October 2026, lists no product containing aviptadil¹¹. FDA granted aviptadil orphan drug designation for sarcoidosis on 23 July 2020 (sponsor Relief Therapeutics); its database notes that it is not FDA-approved for that use⁴². The COVID-AIV trial ran under FDA fast track designation⁹. NRx Pharmaceuticals asked FDA on 1 June 2021 to authorize IV aviptadil (Zyesami) for emergency use in critical COVID-19²⁸. FDA declined on 4 November 2021, citing insufficient data on benefits and risks, and noted that it had reviewed safety in only 131 randomized patients given the drug²⁹. A second request, filed on 5 January 2022 for patients at immediate risk of death despite remdesivir, was declined on 1 July 2022; NRx said that request rested on a post-hoc subgroup analysis and that FDA had also declined Breakthrough Therapy designation³⁰⁴³.
US pharmacies: VIP, listed as “Vasoactive Intestinal Peptide”, is in Category 1 of FDA’s 503A bulk drug substances list (updated 14 May 2026), the group of substances under evaluation¹². FDA says it does not intend to take action against a compounder for using a Category 1 substance, provided the conditions in its guidance are met, such as an ingredient made at an FDA-registered facility with a valid certificate of analysis¹³. This is a temporary enforcement policy, not approval and not a final listing. VIP is not on the 503B list for outsourcing facilities (updated 21 March 2025) or on FDA’s page of bulk substances that may present significant safety risks (current 22 April 2026)⁴⁴⁴⁵. A US compounding pharmacy sells a prescription VIP nasal spray, says it is primarily used for chronic inflammatory response syndrome, and states that it has not undergone FDA review for safety, effectiveness or quality¹.
Other countries: Sweden: Invicorp, an injection of 25 µg aviptadil with 2 mg phentolamine, is a prescription medicine for erectile dysfunction in adult men; it was first approved in May 2015 and renewed on 21 February 2020, and its product information was last revised on 9 July 2026¹⁴. UK: a 2017 Welsh assessment gave a UK marketing authorization date of 21 April 2015, and the Scottish Medicines Consortium accepted Invicorp in 2017 for restricted use in men for whom tablets and other non-injected treatments have failed³⁷⁴⁶; its current UK status was not verified. Denmark lists Invicorp with a pharmacy price⁴⁷. India: the national drug regulator lists an aviptadil injection approved on 29 April 2022 for restricted emergency use in severe COVID-19 with acute respiratory distress syndrome⁴¹. EU: aviptadil holds orphan designations for acute lung injury (2006) and sarcoidosis (2007), granted to mondoBIOTECH; EMA notes that an orphan designation is not a marketing authorization⁷²⁷. Canada: Health Canada listed VIP among unauthorized injectable peptides seized from a Calgary clinic (1 April 2025) and from the online seller Canada Peptide (1 August 2025)²¹²². Australia: aviptadil is a prescription-only medicine (Schedule 4) in the October 2026 Poisons Standard¹⁵. Other countries were not verified.
Sport: VIP and aviptadil are not named on the World Anti-Doping Agency’s 2026 Prohibited List or on the 2027 List, published 21 September 2026 and in force from 1 January 2027¹⁶¹⁷. Class S0 bans only substances with no current approval by any government health authority for human therapeutic use; because aviptadil is approved in Sweden as part of Invicorp, S0 should not apply, by our reading¹⁴¹⁶. By our reading it also does not fit the S2 classes, which cover red-cell boosters, testosterone-raising peptides, corticotrophins, growth hormone and its releasing factors, and growth factors¹⁶.

VIP (vasoactive intestinal peptide) in the legal tracker →

Quality and the gray market

What testing finds

As of 7 October 2026, Finnrick, an independent peptide-testing service, listed no VIP sellers and no test results (“No published VIP tests yet”)¹⁸. We found no other independent lab tests of VIP sold online. Seller pages cite their own certificates of analysis, such as one reporting 99.89% purity, which we could not verify²⁰. Health Canada warns that unauthorized injectable peptides may contain too much, too little or none of the active ingredient, or contaminants such as solvents, heavy metals, particles, bacteria or bacterial toxins⁴⁹. Pharmacy-compounded VIP is made to order and, as one pharmacy states, has not undergone FDA review for quality¹.

How it is sold

VIP reaches buyers in two ways. US compounding pharmacies sell it by prescription as a nasal spray, marketed mainly for mold illness, with claims about nerve repair, brain inflammation, hormones and blood sugar¹; we found no trial that tested those claims. A 2024 review that favors the Shoemaker treatment plan called VIP its most expensive step: not covered by insurance, available only through compounding pharmacies, and costing more than $300 a month². Online peptide sellers also offer 10 mg powder vials labeled for research use only, at $69 to $75 a vial as of 7 October 2026¹⁹²⁰. A community dosing guide covers both injections under the skin and nasal sprays⁴⁸. In 2025 Health Canada reported seizing products labeled VIP from a Calgary clinic and from an online seller²¹²². We found no independent demand data, such as test requests or search trends.

Side effects and risks

Unproven benefit for its main use: we found no test of VIP against a placebo for mold illness, and a 2019 review, which did not name CIRS, says the existence of toxic mold syndrome has been disproven²³⁶.
Low blood pressure: VIP widens blood vessels and lowers blood pressure⁶. A compounding pharmacy lists low blood pressure, headache, dizziness, stomach discomfort and flushing as possible side effects of its nasal spray, and a 2024 review lists light-headedness¹².
Diarrhea: in the COVID-AIV trial, 32.8% of patients on IV aviptadil had diarrhea versus 1.5% on placebo⁹.
Flushing and priapism with erection shots: flushing followed 40% of injections in a 236-man trial, and one priapism (a prolonged erection that needs urgent care) occurred in 1,711 injections⁸. The Swedish label warns of prolonged erections and priapism¹⁴.
In the largest trial, death, serious events, organ failure, serious infection or severe side effects in the first 5 days occurred in 63% of patients on aviptadil versus 56% on placebo, a difference that could be due to chance⁴.
Unknown long-term safety: long-term data come only from small open-label nasal-spray studies, such as one in 20 people over at least 18 months¹⁰, and we found no study in people of injections under the skin.
Product quality: no independent tests of VIP sold online were found, and unauthorized peptides may be mislabeled or contaminated¹⁸⁴⁹.
Legal risk: research-use-only vials are not approved for human use, and Health Canada has seized VIP products²⁰²¹²².

Documented harms

30 Jul 2026FDA’s adverse event database (FAERS, via openFDA, data updated 30 July 2026) holds 33 reports naming aviptadil, Zyesami, Invicorp or VIP; 31 are coded serious. Aviptadil is a suspect drug in 11 reports from the US and UK dated 14 October 2021 to 3 March 2023, two of which record a death; all 11 also list remdesivir and 7 list placebo, the pattern of a blinded trial. In the other reports, VIP was only a background medicine. Reports are unverified and do not prove the drug caused the event⁵⁰.
1 Aug 2025Health Canada warned that unauthorized injectable peptides seized from and sold by Canada Peptide, including VIP, may pose serious health risks²¹.
1 Apr 2025Health Canada seized unauthorized injectable peptides from the Optimum Wellness Centre in Calgary, including a product listed as “VIP without Mannitol”²².
Sep 2023In TESICO, death, serious adverse events, organ failure, serious infection or grade 3 or 4 adverse events by day 5 occurred in 146 of 231 patients on aviptadil (63%) and 129 of 230 on placebo (56%; p = 0.10)⁴.
1 Nov 2022In COVID-AIV, mild-to-moderate diarrhea affected 32.8% of patients on IV aviptadil versus 1.5% on placebo; low blood pressure was common in both groups (26.0% vs 21.5%) and was treated with blood-pressure drugs⁹.

Questions people ask

What is VIP peptide used for?

In the US it is sold mainly as a compounded nasal spray for mold illness, also called chronic inflammatory response syndrome (CIRS)¹. As the drug aviptadil, it has been tested in COVID-19 lung failure, pulmonary hypertension and sarcoidosis, and Sweden approves it in an erection injection^4142435.

Is VIP peptide FDA approved?

No. Drugs@FDA lists no aviptadil product, and FDA declined emergency use authorization for IV aviptadil (Zyesami) in COVID-19 twice, in 2021 and 2022¹¹²⁹³⁰. US pharmacies may compound it for now while FDA evaluates it¹².

Does VIP nasal spray work for mold illness (CIRS)?

We found no test of it against a placebo. The main evidence is three small open-label studies from Shoemaker’s research group, rated nonexperimental even by a review that favors the treatment²¹⁰. As of 7 October 2026, the US trial registry listed no trial of VIP for this condition³.

Is VIP the same as aviptadil?

Yes. Aviptadil is the drug name for lab-made VIP, which the European Medicines Agency describes as identical to the natural hormone⁷. Zyesami was NRx Pharmaceuticals’ brand name for IV aviptadil, and Invicorp combines aviptadil with phentolamine¹⁴²⁹.

What are the side effects of VIP peptide?

In a COVID-19 trial, 32.8% of patients on IV aviptadil had diarrhea, versus 1.5% on placebo⁹. Erection injections that add phentolamine often cause flushing and rarely priapism⁸. A compounding pharmacy lists headache, dizziness, stomach discomfort, flushing and low blood pressure for its nasal spray¹.

What is the half-life of VIP?

Very short. VIP from an Invicorp dose had a half-life of 1.7 minutes after IV injection and 5.3 minutes after injection into the penis¹⁴. A 1978 study in volunteers found an average of one minute²⁵.

Is VIP banned in sports?

It is not named on the World Anti-Doping Agency’s 2026 or 2027 Prohibited Lists¹⁶¹⁷. Because aviptadil is approved in Sweden in Invicorp, the catch-all ban on unapproved substances should not apply, by our reading¹⁴.

Can pharmacies compound VIP peptide?

Yes, for now. FDA lists VIP in Category 1 for state-licensed (503A) pharmacies, meaning it does not intend to take action against compounding it while it evaluates the substance, if conditions are met¹²¹³. This is not FDA approval.

What is still unknown

Whether the placebo-controlled trial of VIP nasal spray that Shoemaker’s group said in 2013 had begun was ever completed or published; we found no registry record.
How much nasal VIP reaches the bloodstream or brain; we found no human data on nasal absorption or half-life.
Safety and effect of daily injections under the skin, as listed on community and seller pages; no human study was found.
Current UK status of Invicorp: the 2015 authorization and the 2017 Scottish advice are documented, but the current UK listing could not be checked.
Approval status outside Sweden, Denmark, the UK and India was not verified.
EMA states that aviptadil also holds US orphan designations for respiratory distress syndrome and pulmonary arterial hypertension; we confirmed only the 2020 sarcoidosis designation in FDA’s database.
The inhaled dose in the 2010 sarcoidosis study is not stated in its abstract.
No independent lab tests of VIP sold online were found as of 7 October 2026, so purity, dose accuracy and contamination are unknown.
Whether chronic inflammatory response syndrome is a distinct illness is disputed; the 2024 review that supports it and the 2019 mold review cited here disagree.

Sources

1VIP (Vasoactive Intestinal Peptide) nasal spray, compounded medication page Strive Pharmacy (vendor), accessed 7 Oct 2026. strivepharmacy.com (seller page, deliberately not linked)
2Chronic inflammatory response syndrome: a review of the evidence of clinical efficacy of treatment Annals of Medicine and Surgery, Dec 2024. pmc.ncbi.nlm.nih.gov
3ClinicalTrials.gov search: chronic inflammatory response syndrome, mold illness, water-damaged building or biotoxin (5 records, none testing VIP) ClinicalTrials.gov, accessed 7 Oct 2026. clinicaltrials.gov
4Intravenous aviptadil and remdesivir for treatment of COVID-19-associated hypoxaemic respiratory failure in the USA (TESICO): a randomised, placebo-controlled trial The Lancet Respiratory Medicine, Sep 2023. pubmed.ncbi.nlm.nih.gov
5Polypeptide with broad biological activity: isolation from small intestine Science, 18 Sep 1970. pubmed.ncbi.nlm.nih.gov
6VIP_HUMAN (P01282): VIP peptides, the vasoactive intestinal peptide precursor UniProt Consortium, 2 Sep 2026. uniprot.org
7EU/3/06/395: orphan designation for treatment of acute lung injury (aviptadil) European Medicines Agency, 2 Apr 2009. ema.europa.eu
8Treating men with predominantly nonpsychogenic erectile dysfunction with intracavernosal vasoactive intestinal polypeptide and phentolamine mesylate in a novel auto-injector system: a multicentre double-blind placebo-controlled study BJU International, Feb 1999. pubmed.ncbi.nlm.nih.gov
9The Use of IV Vasoactive Intestinal Peptide (Aviptadil) in Patients With Critical COVID-19 Respiratory Failure: Results of a 60-Day Randomized Controlled Trial Critical Care Medicine, 1 Nov 2022. pmc.ncbi.nlm.nih.gov
10Vasoactive intestinal polypeptide (VIP) corrects chronic inflammatory response syndrome (CIRS) acquired following exposure to water-damaged buildings Health (Scientific Research Publishing), Mar 2013. scirp.org
11Drugs@FDA via openFDA: search for active ingredient aviptadil (no matches) U.S. Food and Drug Administration (openFDA), 6 Oct 2026. api.fda.gov · data query
12Bulk Drug Substances Nominated for Use in Compounding Under Section 503A of the Federal Food, Drug, and Cosmetic Act (categories list) U.S. Food and Drug Administration, 14 May 2026. fda.gov
13Bulk Drug Substances Used in Compounding Under Section 503A of the FD&C Act U.S. Food and Drug Administration, 14 May 2026. fda.gov
14Invicorp (injektionsvätska, lösning 25 mikrogram/2 mg): produktresumé (summary of product characteristics, Swedish) Evolan Pharma AB via FASS (Sweden), 9 Jul 2026. fass.se
15Therapeutic Goods (Poisons Standard—October 2026) Instrument 2026 (F2026L01327) Federal Register of Legislation, Australian Government, 28 Sep 2026. legislation.gov.au
16World Anti-Doping Code International Standard: Prohibited List 2026 World Anti-Doping Agency, 24 Sep 2025. wada-ama.org
17World Anti-Doping Code International Standard: Prohibited List 2027 World Anti-Doping Agency, 21 Sep 2026. wada-ama.org
18VIP Safety Testing Results & Vendor Ratings Finnrick, accessed 7 Oct 2026. finnrick.com
19VIP (Vasoactive Intestinal Peptide) 10mg product page PeakLab (vendor), accessed 7 Oct 2026. peaklabpeptides.com (seller page, deliberately not linked)
20VIP 10mg product page Protide Health (vendor), accessed 7 Oct 2026. protidehealth.com (seller page, deliberately not linked)
21Unauthorized injectable peptide drugs seized and sold by Canada Peptide may pose serious health risks (RA-77807) Health Canada, 1 Aug 2025. recalls-rappels.canada.ca
22Unauthorized injectable peptide drugs seized from Optimum Wellness Centre in Calgary, Alberta may pose serious health risks (RA-77218) Health Canada, 1 Apr 2025. recalls-rappels.canada.ca
23KEGG DRUG: Aviptadil (D12127) KEGG, Kanehisa Laboratories, accessed 8 Oct 2026. kegg.jp
24Inhaled vasoactive intestinal peptide exerts immunoregulatory effects in sarcoidosis American Journal of Respiratory and Critical Care Medicine, 15 Aug 2010. pubmed.ncbi.nlm.nih.gov
25Vasoactive intestinal peptide in man: pharmacokinetics, metabolic and circulatory effects Gut, Nov 1978. pubmed.ncbi.nlm.nih.gov
26A clinical trial of intracavernous vasoactive intestinal peptide to induce penile erection The Journal of Urology, Feb 1990. pubmed.ncbi.nlm.nih.gov
27EU/3/07/473: orphan designation for treatment of sarcoidosis (aviptadil) European Medicines Agency, 22 Jan 2008. ema.europa.eu
28NRx Pharmaceuticals Announces Positive Results for ZYESAMI™ (Aviptadil-acetate) and Submits Emergency Use Authorization Application to US Food and Drug Administration to Treat Critical COVID-19 in Patients Suffering from Respiratory Failure NRx Pharmaceuticals via PR Newswire, 1 Jun 2021. prnewswire.com
29US Food and Drug Administration Declines Emergency Use Authorization for ZYESAMI® (aviptadil) for Patients with Critical COVID-19 with Respiratory Failure NRx Pharmaceuticals via PR Newswire, 4 Nov 2021. prnewswire.com
30FDA Declines Emergency Use Authorization for ZYESAMI® (aviptadil) for subgroup of Patients with Critical COVID-19 at immediate risk of death from respiratory failure despite treatment with approved therapy, including remdesivir NRx Pharmaceuticals via PR Newswire, 1 Jul 2022. prnewswire.com
31Aviptadil for COVID-19: A Case Study and Call to Action About the Challenges of Research During a Global Pandemic Critical Care Medicine, 1 Nov 2022. pmc.ncbi.nlm.nih.gov
32Aviptadil Therapy in Acute Respiratory Distress Syndrome Patients: A Systematic Review and Meta-analysis Indian Journal of Critical Care Medicine, Nov 2025. pubmed.ncbi.nlm.nih.gov
33Inhaled Aviptadil Is a New Hope for Recovery of Lung Damage due to COVID-19 Medical Principles and Practice, 2025. pmc.ncbi.nlm.nih.gov
34Vasoactive intestinal peptide as a new drug for treatment of primary pulmonary hypertension Journal of Clinical Investigation, May 2003. pubmed.ncbi.nlm.nih.gov
35Inhalation of vasoactive intestinal peptide in pulmonary hypertension European Respiratory Journal, Nov 2008. pubmed.ncbi.nlm.nih.gov
36The Myth of Mycotoxins and Mold Injury Clinical Reviews in Allergy & Immunology, Dec 2019. pubmed.ncbi.nlm.nih.gov
37AWMSG Secretariat Assessment Report: aviptadil/phentolamine mesilate (Invicorp) 25 micrograms/2 mg solution for injection, reference number 3435 All Wales Therapeutics and Toxicology Centre, May 2017. awttc.nhs.wales
38Intracavernosal injection of aviptadil and phentolamine for refractory erectile dysfunction The Journal of Sexual Medicine, 10 May 2025. pubmed.ncbi.nlm.nih.gov
39Vasoactive intestinal peptide prevents experimental arthritis by downregulating both autoimmune and inflammatory components of the disease Nature Medicine, May 2001. pubmed.ncbi.nlm.nih.gov
40Therapeutic effects of vasoactive intestinal peptide in the trinitrobenzene sulfonic acid mice model of Crohn’s disease Gastroenterology, Apr 2003. pubmed.ncbi.nlm.nih.gov
41List of new drugs approved in the year 2022 till date Central Drugs Standard Control Organisation, India, 2022. cdsco.gov.in
42Orphan drug designation: aviptadil for treatment of sarcoidosis U.S. Food and Drug Administration, Office of Orphan Products Development, 23 Jul 2020. accessdata.fda.gov
43NRx Pharmaceuticals Submits Emergency Use Authorization Application to US Food and Drug Administration for ZYESAMI® (aviptadil) to Treat Patients at Immediate Risk of Death from COVID-19 Despite Treatment with Remdesivir and Other Approved Therapies NRx Pharmaceuticals via PR Newswire, 5 Jan 2022. prnewswire.com
44Bulk Drug Substances Nominated for Use in Compounding Under Section 503B of the Federal Food, Drug, and Cosmetic Act (categories list) U.S. Food and Drug Administration, 21 Mar 2025. fda.gov
45Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks U.S. Food and Drug Administration, 22 Apr 2026. fda.gov
46aviptadil / phentolamine mesilate 25 micrograms / 2mg solution for injection (Invicorp), SMC No 1284/17 Scottish Medicines Consortium, 11 Dec 2017. scottishmedicines.org.uk
47Invicorp, komb. (medicine information and price) Danmarks Apotekerforening (apoteket.dk), accessed 7 Oct 2026. apoteket.dk
48VIP Dosage Chart: 50mcg SubQ AM/PM Protocol (2026) The Peptide Catalog, 25 Apr 2026. thepeptidecatalog.com
49Think twice before injecting peptides bought online: unauthorized products can seriously harm you (RA-81874) Health Canada, 9 Apr 2026. recalls-rappels.canada.ca
50FDA Adverse Event Reporting System (FAERS) reports naming aviptadil, Zyesami, Invicorp or vasoactive intestinal peptide, retrieved via the openFDA drug/event API (33 reports) U.S. Food and Drug Administration (openFDA), 30 Jul 2026. api.fda.gov · data query

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